Wednesday, December 21, 2011

Mediterranean diet gives longer life

A Mediterranean diet with large amounts of vegetables and fish gives a longer life. This is the unanimous result of four studies to be published by the Sahlgrenska Academy at the University of Gothenburg. Research studies ever since the 1950s have shown that a Mediterranean diet, based on a high consumption of fish and vegetables and a low consumption of animal-based products such as meat and milk, leads to better health.

21 dec 2011--Scientists at the Sahlgrenska Academy have now studied the effects of a Mediterranean diet on older people in Sweden. They have used a unique study known as the "H70 study" to compare 70-year-olds who eat a Mediterranean diet with others who have eaten more meat and animal products. The H70 study has studied thousands of 70-year-olds in the Gothenburg region for more than 40 years.

The results show that those who eat a Mediterranean diet have a 20% higher chance of living longer. "This means in practice that older people who eat a Mediterranean diet live an estimated 2 3 years longer than those who don't", says Gianluca Tognon, scientist at the Sahlgrenska Academy, University of Gothenburg.

These results are supported by three further as yet unpublished studies into Mediterranean diets and their health effects: one carried out on people in Denmark, the second on people in northern Sweden, and the third on children.

"The conclusion we can draw from these studies is that there is no doubt that a Mediterranean diet is linked to better health, not only for the elderly but also for youngsters", says Gianluca Tognon.

Provided by University of GothenburgLink

Monday, December 19, 2011

Polyphenol-rich diet could reduce cardiovascular risk

19 dec 2011-- A diet high in polyphenols could help reduce the risk of cardiovascular disease and associated health risks, according to a new study by the University of Glasgow.

Researchers in the Institute of Cardiovascular and Medical Sciences (ICAMS) and Mosaique Diagnostics recruited 39 overweight volunteers, with a body mass index greater than 25, and gave half of them a fruit drink rich in polyphenols – naturally-occurring chemicals found in many plants – and the other half a placebo.

The drink used in the study was specially developed by the scientists and The Coca-Cola Company to contain polyphenolic compounds from a range of sources, including: green tea, grape seed, lemons and apples.

After two weeks, scientists took urine samples from the participants and subjected them to proteomic analysis.

Proteomics is a developing field of medicine which seeks to identify a range of proteins produced in the body which can be monitored to identify the development of particular disease states, long before symptoms are evident.

By knowing which proteins – or biomarkers – change when a disease is in its early stages of development, doctors might be able to prevent or reverse the disease’s progress, or to begin therapeutic treatment earlier.

The research found a total of 27 proteins that were significantly different between the two groups, including five that are associated with reduced risk cardiovascular disease.

Professor Harald Mischak, Professor of Proteomics and founder of Mosaique Diagnostics, said: “While the epidemiological data supports the idea that a diet rich in fruit and vegetables is beneficial to health, clinical studies have generally not adequately confirmed this. Our data indicates that proteomic analysis can be a powerful tool to assess potential positive effects of dietary products.

“Our pilot study suggests that as far as polyphenol-containing fruit drinks go, there are possible benefits for cardiovascular health, which deserve further consideration in longer term trials.

“Given the recommended daily intake of five 80g portions of fruit and vegetables a day is taken by around just a quarter of Britons and less than half of Americans, fruit juices and juice drinks fortified with polyphenols represent a potential way for some consumers to meaningfully increase their intake of such potentially beneficial compounds, although the long term effects remain to be elaborated.”

Dr William Mullen, Director of Biomarker Research at the University of Glasgow, said: “The long-term goal of clinical proteomics is to identify biomarkers for a range of diseases that would allow early detection and treatment.

“However, finding a single ‘ideal’ compound that can do this is an unlikely prospect, but by using a ‘fingerprint’ of a number of proteins we can identify pre-symptomatic development of a range of diseases, from coronary artery disease to chronic kidney disease and diabetes. We have developed a range of biomarkers from urine samples for clinical diagnostics that are highly sensitive and selective for a range of diseases. These biomarkers are in effect ‘urinary fingerprints’ of diseases.

“This technology and approach also has potential for use in nutrition and health research, as our study has demonstrated.

“This study was small and did not allow the testing of all proteomics data so we need larger, more in-depth studies to develop this potential further, and we need longer term studies to link patterns to disease outcomes.

“The technology of this method has been found to be acceptable for use in clinical studies by the US Food & Drug Administration and many diseases can be analysed with just one urine sample.”

The research, published in the Journal of Agricultural and Food Chemistry, was led by Professor Naveed Sattar and funded by The Coca-Cola Company.

Provided by University of Glasgow

Saturday, December 17, 2011

Doctors should tell patients the realities of aging

Dr. Alexander K. Smith hopes to provoke a national discussion about being frank with the very elderly about their individual medical prognosis.

18 dec 2011--In his recent paper on the issue published by the New England Journal of Medicine, he makes a strong case for outlining the future in frank terms - provided the elder wants to hear it.

"Studies show patients want to discuss the realities of aging but they may be waiting for the physician to bring it up," says Smith, who is an assistant professor of medicine at the University of California San Francisco and an associate of the San Francisco Veterans Affairs Medical Center.

"Often it's the doctor who doesn't want to talk about it," he says.

Here Smith discusses the issue:

Q: You admit not all patients want to know the details of their future, medically. For those who are interested, what's the problem?

A: As I write in this paper, co-authored by Dr. Brie A. Williams and Dr. Bernard Lo, despite knowing that life expectancy inexorably decreases with advancing age, we tend to avoid discussing overall prognosis with elderly patients, particularly those with no dominant terminal illness. By avoiding such discussions, however, we may undercut the ability of patients and their caregivers to make informed choices for their future.

Q: You say discussing these individual issues with elderly patients should be the norm. Seems this should already be routine and not the topic of such serious debate.

A: Well, the idea of patient activism is relatively new. There has been, in the past, strong pressure to deny the realities of aging. We know a substantial number of patients want to talk about this now. But we have to respect those who don't. It depends on the person. I have patients who are 100 who won't admit their time is limited.

Q: Is this a way to reduce overall health costs? I mean, if I know that the cancer I have is going to kill me eventually, why bother to spend the money to treat it in the end days of life? By denying treatment to those it will not substantially benefit with many more years of good health, we could reduce Medicare costs significantly.

A: When patients are aware of the options, they often make choices themselves that reduce the cost of care. But it is our job to support the patient's goals and aspirations. I absolutely am not suggesting we tell people that the eventual outcome of this treatment will not benefit them so we aren't going to do it because of the expense.

Right now, we are doing a study to find out why patients will talk about a short-term prognosis but generally aren't willing to talk about five or 10 years ahead.

We need to set a balance but we also must give hope. So many are living longer comfortably with disabilities that once were painful.

Q: In your paper you suggest that clinicians should routinely offer to discuss the overall prognosis for elderly patients with a life expectancy of less than 10 years Â- or at least by the time a patient reaches 85 - and that the older and frail should be encouraged to talk about reducing the pill burden and engaging in advanced care planning.

A: Most of the very elderly patients place great emphasis on the harms as well as the benefits of medications (but) clinicians may fear talking about or even raising the topic of overall prognosis because it may seem threatening to patients and family members....

Whereas clinicians consider overall prognosis in order to inform medial decision-making, in our experience, many very elderly patients are interested in it because it affects personal life choices Â- motivating them, for instance, to arrange finances for long-term care or to prioritize spending time with grandchildren and other family members while they are active.

Q: Some of the common medical decisions and life choices that you say offer opportunities to discuss overall prognosis with the elderly are assessing the appropriateness of high-risk surgery or initiating renal dialysis in an elderly patient.

A: Not withstanding large current gaps in evidence, we believe we should start talking about overall prognosis now, even as we carry out more research on patient preferences and ways of improving such discussions. To make our care more patient-centered, we need to start helping our very elderly patients set goals of care that take their overall prognosis into account. We should do so in the ordinary course of clinical practice, letting our patients be our guides.

Friday, December 16, 2011

Biochemical signature predicts progression to Alzheimer's disease

A study led by Research Professor Matej Orešič from VTT Technical Research Centre of Finland suggests that Alzheimer's disease is preceded by a molecular signature indicative of hypoxia and up-regulated pentose phosphate pathway. This indicator can be analysed as a simple biochemical assay from a serum sample months or even years before the first symptoms of the disease occur. In a healthcare setting, the application of such an assay could therefore complement the neurocognitive assessment by the medical doctor and could be applied to identify the at-risk patients in need of further comprehensive follow-up.

16 dec 2011--Alzheimer's disease (AD) is a growing challenge to the health care systems and economies of developed countries with millions of patients suffering from this disease and increasing numbers of new cases diagnosed annually with the increasing ageing of populations.

The progression of Alzheimer's disease (AD) is gradual, with the subclinical stage of illness believed to span several decades. The pre-dementia stage, also termed mild cognitive impairment (MCI), is characterised by subtle symptoms that may affect complex daily activities. MCI is considered as a transition phase between normal aging and AD. MCI confers an increased risk of developing AD, although the state is heterogeneous with several possible outcomes, including even improvement back to normal cognition.

What are the molecular changes and processes which define those MCI patients who are at high risk of developing AD? The teams led by Matej Orešič from VTT and Hilkka Soininen from the University of Eastern Finland set out to address this question, and the results were published on 13th Dec. 2011 in Translational Psychiatry.

The team used metabolomics, a high-throughput method for detecting small metabolites, to produce profiles of the serum metabolites associated with progression to AD. Serum samples were collected at baseline when the patients were diagnosed with AD, MCI, or identified as healthy controls. 52 out of 143 MCI patients progressed to AD during the follow-up period of 27 months on average. A molecular signature comprising three metabolites measured at baseline was derived which was predictive of progression to AD. Furthermore, analysis of data in the context of metabolic pathways revealed that pentose phosphate pathway was associated with progression to AD, also implicating the role of hypoxia and oxidative stress as early disease processes.

The unique study setting allowed the researchers to identify the patients diagnosed with MCI at baseline who later progressed to AD and to derive the molecular signature which can identify such patients at baseline.

Though there is no current therapy to prevent AD, early disease detection is vital both for delaying the onset of the disease through pharmacological treatment and/or lifestyle changes and for assessing the efficacy of potential AD therapeutic agents. The elucidation of early metabolic pathways associated with progression to Alzheimer's disease may also help in identifying new therapeutic avenues.Link

More information: M. Orešič, T. Hyötyläinen, S.-K. Herukka, M. Sysi-Aho, I. Mattila, T. Seppänan-Laakso, V. Julkunen, P. V. Gopalacharyulu, M. Hallikainen, J. Koikkalainen, M. Kivipelto, S. Helisalmi, J. Lötjönen, H. Soininen, Metabolome in progression to Alzheimer's disease, Translational Psychiatry, 13th December 2011.

Provided by VTT Technical Research Centre of Finland

Wednesday, December 14, 2011

Despite guidelines, elderly receiving too many cancer screenings

14 dec2011-- Despite guidelines from a major medical group recommending limited – or no – screenings for four types of cancer for people in their 60s, 70s, and 80s, a UConn researcher has found that more than half of elderly adults continue to receive the screenings.

Keith Bellizzi, an assistant professor in the Department of Human Development and Family Studies in the College of Liberal Arts and Sciences, says that despite the U.S. Preventive Services Task Force guidelines against routine screening for breast, colorectal, cervical, and prostate cancer at the age of 75 years (65 for cervical cancer), more than 50 percent of physicians continue to recommend the tests. High rates continue for people in their 80s.

Bellizzi found that elderly Hispanics and African Americans were screened less often than Caucasians, differences accounted for by lower educational attainment in these two groups compared to Caucasians.

The USPSTF guidelines recommend against routine cervical cancer screenings in women older than 65; ending routine screening for mammography and colorectal cancer in adults 75 or older; and against screening for prostate cancer in men 75 and older. Other agencies and organizations also recommend fewer screenings for the elderly.

“These findings reinforce the need to examine factors that physicians consider in deciding to screen their patients, and underscores the critical role for health care providers to make informed screening decisions for their patients,” says Bellizzi.

The study will be published later this month in the Archives of Internal Medicine, a publication of the American Medical Association. Joining Bellizzi in the work was Erica Breslau and Allison Burness of the National Cancer Institute.

Bellizzi analyzed data from the CDC’s National Health Interview Survey, an annual in-person nationwide survey used to track health trends in American citizens, to estimate the prevalence of cancer screening among older adults in different racial groups. The study population of 49,575 individuals included 1,697 who were 75 to 79 years of age and 2,376 who were 80 years of age and older.

“In the United States, the number of adults 65 years or older, currently estimated at 36.8 million, is expected to double by the year 2030. Providing high-quality care to this growing population while attempting to contain costs will pose a significant challenge,” Bellizzi says. “While a great deal is known about cancer screening behaviors and trends in young and middle-aged adults, less is known about screening behaviors in older adults from different racial backgrounds.”

Historically, older adults have been excluded from cancer screening trials, so screening efficacy data on this population is limited, Bellizzi says. Research also is needed to determine the value of continued screening in elderly Americans, and whether the benefits – potentially longer lives – outweigh the negatives: complications from tests, false positives putting unneeded stress on the patient and their families, treatment of clinically unimportant cancers, distress, and anxiety.

“Older adults are becoming increasingly heterogeneous with respect to health status because of earlier lifestyle behaviors and health trajectories,” Bellizzi says. “As such it is quite likely that continued screening for certain segments of the older adult population is warranted.

“At the same time, there are segments of the older adult population with limited life expectancy, poor health status, and concomitant health conditions that would likely not benefit from screening. The challenge is how do we make this determination,” he says.

Done properly, he adds, “we would improve the quality of care in the older population, while containing health care costs.”

Provided by University of Connecticut

Tuesday, December 13, 2011

Study: No decline in running economy for older runners

Runners over the age of 60 are the fastest-growing group in the sport. A new study from the University of New Hampshire suggests that their running can remain fast as they age, too.

13 dec 2011--The study, published in the Journal of Strength and Conditioning Research, found that the running economy – how efficiently the body uses oxygen at a certain pace – of older runners was no different than that of younger runners. "That really jumped off the page. It was surprising, but in a good way," says lead author Timothy Quinn, who is an associate professor of exercise science at UNH.

Yet in general older runners are slower than younger ones, which is why races segment competitors by age. Moderating the good news about running economy, Quinn and his colleagues found that maintaining this running economy came at a higher "cost" to senior runners. Their VO2 max, which measures the body's capacity to transport and use oxygen during exercise, was significantly lower than their younger peers, as were their maximal heart rates.

"For the runners over age 60, it's physiologically more difficult to run at that speed, even though the absolute oxygen uptake value is the same as a younger runner," says Quinn. In other words, it will feel harder.

Working with competitive male and female distance runners who had all finished first, second or third place in their age categories in large local road races, the researchers grouped their subjects as young (18-39 years), master (40-59 years) and older (60 years and over). In addition to running economy, Quinn and co-authors, who include former UNH exercise science graduate student and instructor Michelle Manley and former clinical assistant professor Allison MacKenzie (now at the University of Buffalo), looked at other factors – strength, power, and flexibility -- that might explain how running performance declines with age.

The older runners fared significantly worse than younger ones on all three measures, helping pinpoint the sources of age-related performance declines. Strength, in particular upper-body strength, is necessary to propel runners uphill and to hasten leg turnover, says Quinn. Muscle power – how fast that strength is generated – governs the speed at which runners can change speed or direction or run up hills. And flexibility, measured in this study with a sit-and-reach test to assess hamstring and lower back flexibility, correlates with stride length and step frequency.

These findings should by no means suggest that older runners should hang up their sneakers, the researchers say. "Strength declines with age, but you can minimize that if you do strength training. It doesn't take a lot to maintain strength," says Quinn. "We need to set up programs that enhance strength, especially upper-body strength, and power. They'll be better runners for it."

Quinn, who has done research on running, cardiovascular function, and fitness throughout his two-decade career at UNH, hopes to measure this same group of runners over time, launching a longitudinal study that will shed new light on the performance of runners as they age.

More information: An abstract of the study, "Aging and Factors Related to Running Economy," is available to download here: http://journals.lw … nomy.5.aspx.

Provided by University of New Hampshire

Monday, December 12, 2011

Socially active older adults have slower rates of health declines

Socially active older adults have slower rates of health declines

Staying connected to other people through a wide variety of social activities can yield important health consequences as you age.

12 dec 2011--That’s the message from a new study that found that older adults who maintain high levels of social activity or ramp up their social life as they age might be protected from increases in physical and cognitive issues over time.

“People have some control over their social lives, so it is encouraging to find that something many people find enjoyable—socializing with others—can benefit their cognitive and physical health,” said study author Patricia A. Thomas, Ph.D., of the Population Research Center at University of Texas at Austin.

While earlier research had established a link between health and social relations, this study sought to examine how changing social connections over time influenced health. While the elderly are vulnerable to losing formal social roles through retirement or the death of a spouse, they could still seek out social activities in other arenas.

In the study, which appears online in the December issue of the Journal of Health and Social Behavior, the researchers analyzed data from a sample of 1,667 adults older than 60 years. Data collection from participants occurred in 1986, 1989, 1994 and 2002. Participants were asked about their frequency of social activities, such as visiting with friends and family members; attending meetings, programs or clubs; and volunteering in the community over the previous 12 months. They also answered questions about cognitive and physical limitations.

Older adults who had high initial levels of social engagement that only slightly decreased over time and those who had high or medium levels of engagement that increased over time developed cognitive and physical limitations more slowly than did those with low levels of engagement that decreased over time.

Thomas pointed out, “Even if older adults weren’t socially active when they were younger, when they increase social activity later in life, it can still reduce physical and cognitive health issues.”

Asenath La Rue, Ph.D., a neuropsychologist with the Wisconsin Alzheimer's Institute at the University of Wisconsin School of Medicine and Public Health, agreed with the study’s main finding. La Rue said there has not been much reporting about the benefits gained from social interaction if a person was not socially connected when younger. “However, it’s like the chicken and egg question about which comes first,” she explained, noting that while the research was observational, epidemiology supports the fact that social interaction is beneficial for cognitive health and physical performance in older adults.

More information: Thomas, P.A. (2011) Trajectories of Social Engagement and Limitations in Late Life. Journal of Health and Social Behavior, 52(4), 430-443.

Provided by Health Behavior News Service

Sunday, December 11, 2011

Aging stem cells may explain higher prevalence of leukemia, infections among elderly

Human stem cells aren't immune to the aging process, according to scientists at the Stanford University School of Medicine. The researchers studied hematopoietic stem cells, which create the cells that comprise the blood and immune system. Understanding when and how these stem cells begin to falter as the years pass may explain why some diseases, such as acute myeloid leukemia, increase in prevalence with age, and also why elderly people tend to be more vulnerable to infections such as colds and the flu.

11 dec 2011--"We know that immune system function seems to decline with increasing age," said Wendy Pang, MD. "This is the first study comparing the function and gene expression profiles of young and old purified, human hematopoietic stem cells, and it tells us that these clinical changes can be traced back to stem cell function."

Specifically, the researchers found that hematopoietic stem cells from healthy people over age 65 make fewer lymphocytes — cells responsible for mounting an immune response to viruses and bacteria — than stem cells from healthy people between ages 20 and 35. (The cells were isolated from bone marrow samples.) Instead, elderly hematopoietic stem cells, or HSCs, have a tendency to be biased in their production of another type of white blood cell called a myeloid cell. This bias may explain why older people are more likely than younger people to develop myeloid malignancies.

The study will be published online Nov. 28 in the Proceedings of the National Academy of Sciences. Pang, who is in the Medical Science Training Program at Stanford, is the first author of the research; professor of pathology Irving Weissman, MD, is the senior author. Weissman is also the director of Stanford's Institute for Stem Cell Biology and Regenerative Medicine.

Pang began the study to understand whether human HSCs aged like mouse HSCs. Previous studies had shown that mouse HSCs change in number and function as a laboratory mouse grows older. She obtained HSCs from 15 healthy elderly people and 28 healthy young people and compared their prevalence, distribution and cell cycle profile.

She found that HSCs comprised a greater proportion of bone marrow cells in older people than in younger people. They were also more likely to be actively dividing than younger HSCs. But their greater numbers and increased proliferation didn't translate into greater efficiency; like a top wobbling out of control as its rotation slows, the aging HSCs instead appear to be unsuccessfully trying to keep up with the demands of everyday life.

When Pang purified the HSCs and grew them in laboratory dishes, she found that HSCs from older people were less able to differentiate into B lymphocytes and more likely to become myeloid cells. Furthermore, immune-deficient laboratory mice given transplants of older, human HSCs exhibited a higher proportion of myeloid to lymphoid cells in their bone marrow in the weeks to months after the transplant.

Finally, Pang examined the gene expression profile of the two sets of human HSCs, as well as five samples of HSCs from people ages 42 to 61. She found that HSCs from elderly donors express comparatively higher levels of several age-related genes associated with the cell cycle, proliferation and development, as well as genes associated with DNA repair and cell death. The higher levels of these genes suggests the cells are less likely to wait quietly on the sidelines until new blood or immune cells are needed and are instead entering the cell cycle inappropriately.

Overall, the results mirror those seen in studies of HSCs from laboratory mice of varying ages. They suggest that human HSCs struggle as a person ages, and that this struggle can sometimes lead not only to inadequate immune responses, but also to inappropriate growth and specific types of blood cancers, such as acute myeloid leukemia. They also contribute valuable information for the study of many other conditions.

"In both mice and humans, the puzzle has been how the system ages," said Weissman, who is also the Virginia & D.K. Ludwig Professor for Clinical Investigation in Cancer Research and a member of Stanford's Cancer Institute. "Because HSCs in old mice and humans are derived from the HSCs they had in their youth, there are two possibilities to describe how these differences occur. Either individual, young HSCs change their gene expression patterns as they age, undergoing heritable adaptations that favor the myeloid lineage, or each young HSC already has a specific lineage bias and is battling for precious niches through the natural selection of aging, which favors those biased toward myeloid cells." Understanding which possibility is true could help clinicians of the future encourage the survival of HSCs with more-appropriate properties in patients with age-related diseases, Weissman believes.

"These findings will also serve as an important baseline for future studies of age-related diseases, such as myeloid dysplastic syndrome, anemia and leukemia," said Pang. "Now that we know how HSCs change and function in elderly individuals who are not ill, we should be able to tease out disease-associated changes from normal age-associated phenomena."

Provided by Stanford University Medical CenterLink

Saturday, December 10, 2011

Alzheimer's vaccine cures memory of mice

Alzheimer's vaccine cures memory of mice


Associate Professor Lars Ittner: "Although we have a long way to go before the vaccine might be available for human use, these early results are very promising."

10 dec 2011-- A vaccine that slows the progression of Alzheimer's disease and other types of dementia has been developed by researchers at the University of Sydney's Brain and Mind Research Institute (BMRI).

The vaccine, which targets a protein known as tau, prevents the ongoing formation of neurofibrillary tangles in the brain of a mouse with Alzheimer's disease.

This progressive neurodegenerative disease affects more than 35 million people worldwide. The tau protein is also involved in front temporal dementia, the second most common form of dementia in people younger than 65 years.

The results of the study which led to the production of the vaccine have been published today in the scientific journal PLoS ONE.

Lead author on the study, Associate Professor Lars Ittner, from the Alzheimer's and Parkinson's Disease Laboratory says: "Our study is the first to show that a vaccine targeting the tau protein can be effective once the disease has already set in.

"The vaccine appears to have a preventative effect: slowing the development of further tangles, rather than clearing existing ones, but the exact mechanism involved is not yet understood," he said.

According to Associate Professor Ittner, scientists have been working on vaccines targeting the amyloid plaques seen in Alzheimer's for many years with a few currently in clinical trials.

"Most of the other vaccines targeting tau were tested only before or around the onset of the disease in animal models, but the vast majority of people with Alzheimer's disease are only diagnosed after the symptoms have appeared.

"We are already collaborating with the US pharmaceutical industry to develop this new vaccine for humans.

"Although we have a long way to go before the vaccine might be available for human use, these early results are very promising and a great reward for the countless hours spent in the lab by me and my team!"

Provided by University of Sydney

Friday, December 09, 2011

Pharmacogenomics study finds rare gene variants critical for personalized drug treatment

The use of genetic tests to predict a patient's response to drugs is increasingly important in the development of personalized medicine. But genetic tests often only look for the most common gene variants. In a pharmacogenomics study published online today in Genome Research (www.genome.org), researchers have characterized rare genetic variants in a specific gene that can have a significant influence in disposition of a drug used to treat cancer and autoimmune disease, a finding that will help improve the effectiveness of personalized care.

09 dec 2011--The drug methotrexate is used to treat cancers such as acute lymphoblastic leukemia, and autoimmune diseases including rheumatoid arthritis. Common genetic variants in the SLCO1B1 gene, which encodes a transporter in the liver important for clearance of medication from the body, are present in 10-15% of the population and affect the efficiency of methotrexate clearance from the body.

Low clearance of methotrexate results in high levels in the blood and increased side effects. Rare variants could also significantly affect drug clearance, but the influence of rare versus common SLCO1B1 variants in methotrexate clearance had not yet been explored.

In this report, an international team of researchers sequenced the exons of SLCO1B1, the gene regions that code for protein, in a cohort of pediatric patients receiving methotrexate, finding rare genetic variants that have an effect on the efficiency of clearance of the drug from the body. "We showed that rare inherited genomic variants, present in as few as 1 in 699 people, account for a significant percentage of variability in blood levels of methotrexate," said Dr. Mary Relling of St. Jude Children's Research Hospital, senior author of the study. "This means that the high blood levels present in 2% of people are due to very rare genetic variants."

The research group then utilized computational algorithms to predict the potential negative impact of genomic variants identified in this study on function of the SLCO1B1 protein in the transport of methotrexate. They then tested these predictions in laboratory cell lines, confirming that these genetic variants conferred lower transport of the drug.

"Our discovery of important but rare coding variants in SLCO1B1 not only has implications for methotrexate, but also possibly for other drugs," explained Dr. Laura Ramsey of St. Jude Children's Research Hospital, primary author of the study. Ramsey noted that SLCO1B1 variants are tested to inform choice of the appropriate dosage of statins, commonly used to treat or prevent high cholesterol.

Ramsey added that clinical genetic tests are currently limited, generally only testing for the most common SLCO1B1 variants. "Our findings that there are additional rare functional coding variants in this gene suggest that genotyping tests would need to expand to include rare variants in order to avoid false negative test results."

Scientists from St. Jude Children's Research Hospital (Memphis, TN), Aarhus University (Aarhus, Denmark), MD Anderson Cancer Center (Houston, TX), the University of Tennessee Health Science Center (Memphis, TN), the Sidney Kimmel Comprehensive Cancer Center (Baltimore, MD), and the University of California, San Francisco (San Francisco, CA) contributed to this study.

More information: The manuscript will be published online ahead of print on December 6, 2011. Its full citation is as follows: Ramsey LB, Bruun GH, Yang W, Trevino LR, Vattathil S, Scheet P, Cheng C, Rosner GL, Giacomini KM, Fan Y, Sparreboom A, Mikkelsen TS, Corydon TJ, Pui C, Evans WE, Relling MV. Rare versus common variants in pharmacogenetics: SLCO1B1 variation and methotrexate disposition. Genome Res doi: 10.1101/gr.129668.111

Provided by Cold Spring Harbor Laboratory

Thursday, December 08, 2011

Cigarettes, diet, alcohol and obesity behind more than 100,000 cancers

Cigarettes, diet, alcohol and obesity behind more than 100,000 cancers08 dec 2011-- More than 100,000 cancers – equivalent to one third of all those diagnosed in the UK each year – are being caused by smoking, unhealthy diets, alcohol and excess weight, according to new research from Queen Mary, University of London.

This figure further increases to around 134,000 when taking into account all 14 lifestyle and environmental risk factors analysed in this study.

This new review of cancer and lifestyle in the UK is the most comprehensive undertaken to date and is published in a supplement to the British Journal of Cancer.

Smoking is far and away the most important lifestyle factor causing 23 per cent of cancers in men and 15.6 per cent in women (nearly one in five cancers).

Overall the review shows that 45 per cent of all cancers in men could be prevented – compared with 40 per cent of all cancers in women.

Professor Max Parkin, a Cancer Research UK epidemiologist based at Queen Mary, University of London, and study author, said “Many people believe cancer is down to fate or ‘in the genes’ and that it is the luck of the draw whether they get it.

“Looking at all the evidence, it’s clear that around 40 per cent of all cancers are caused by things we mostly have the power to change.

“We didn’t expect to find that eating fruit and vegetables would prove to be so important in protecting men against cancer. And among women we didn’t expect being overweight to have a greater effect than alcohol.

“In most cases cancers have multiple causes – for example a cervical cancer can be linked to both HPV infection and smoking. This means it isn’t possible to add up the effects of different lifestyle factors – you’d get more than 100 per cent.”

In this study, the top six risk factors were calculated as follows (the number of cases has been rounded to the nearest hundred).

Overall, one in 25 cancers is linked to occupation and one in 33 to infections.

It is estimated that tobacco smoking, dietary factors, drinking alcohol and bodyweight account for 106,845 or 34 per cent of cancers occurring in 2010. This is based on predicted numbers of cancer cases in 2010, using UK incidence figures for the 15-year period from 1993 to 2007.

Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”

Dr. Harpal Kumar, Cancer Research UK’s chief executive, said: “Leading a healthy life doesn’t guarantee that a person won’t get cancer but this study shows that healthy habits can significantly stack the odds in our favour.

“While we have made tremendous progress in improving the chance of surviving cancer during the last 40 years, we need to make sure people are made aware of the risks of getting the disease in the first place so they can make the healthiest possible lifestyle choices.

“We know that cancer risk can be affected by family history and getting older, but these figures show that we can take positive steps to help reduce our risk of the disease. Stopping smoking, eating a balanced diet, cutting down on alcohol and maintaining a healthy weight could be New Year’s resolutions that help save more lives in future.”

Provided by Queen Mary, University of London

Wednesday, December 07, 2011

Simple blood test diagnoses Parkinson's disease long before symptoms appear

A new research report appearing in the December issue of the FASEB Journal shows how scientists from the United Kingdom have developed a simple blood test to detect Parkinson's disease even at the earliest stages. The test is possible because scientists found a substance in the blood, called "phosphorylated alpha-synuclein," which is common in people with Parkinson's disease, and then developed a way to identify its presence in our blood.

06 dec 2011--"A blood test for Parkinson's disease would mean you could find out if a person was in danger of getting the disease, before the symptoms started," said David Allsop, Ph.D., a researcher involved in the work from the Division of Biomedical and Life Sciences and the School of Health and Medicine at the University of Lancaster, in Lancaster, UK. "This would help the development of medicines that could protect the brain, which would be better for the quality of life and future health of older people."

To develop the blood test for Parkinson's disease, Allsop and colleagues studied a group of people diagnosed with the disease and a second group of healthy people of a similar age. Blood samples from each group were analyzed to determine the levels of phosphorylated alpha-synuclein present. They found those with Parkinson's disease had increased levels of the substance. Based upon these findings, researchers developed a blood test that detects the presence of phosphorylated alpha-synuclein, which could allow for diagnosis of the disease well before symptoms appear but when brain damage has already begun to occur.

"When most people think of Parkinson's disease, they think of the outward symptoms, such as involuntary movements," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "but many people with Parkinson's also develop neurological problems that may be more difficult to detect right away. Having a blood test not only helps doctors rule out other possible causes of the outward symptoms, but it also allows for early detection which can help patients and their caregivers prepare for the possibility of the mental, emotional, and behavioral problems that the disease can cause."

More information: Penelope G. Foulds, J. Douglas Mitchell, Angela Parker, Roisin Turner, Gerwyn Green, Peter Diggle, Masato Hasegawa, Mark Taylor, David Mann, and David Allsop. Phosphorylated α-synuclein can be detected in blood plasma and is potentially a useful biomarker for Parkinson's disease. FASEB J. December 2011 25:4127-4137; doi:10.1096/fj.10-179192

Provided by Federation of American Societies for Experimental Biology

Saturday, December 03, 2011

Diametric shift in 2 protein levels spurs Alzheimer's plaque accumulation

A diametric shift in the levels of two proteins involved in folding, moving and cutting other proteins enables accumulation of the destructive brain plaque found in Alzheimer's disease, researchers report.

03 dec 2011--VPS35 is a protein that folds others into specific positions to unleash their functions. When levels are reduced as they are in aging, it unleashes the normally dormant BACE1, a protein responsible for beta amyloid plaque production, Georgia Health Sciences University researchers report in The Journal of Cell Biology.

When researchers modified a mouse model of Alzheimer's so that VPS35 production was essentially cut in half, BACE1 activity was increased, accelerating aging and development of related problems such as memory deficits and poor communication between brain cells as well as beta amyloid accumulation, said Dr. Wen-Cheng Xiong, developmental neurobiologist and Weiss Research Professor at GHSU and the study's corresponding author.

It was known that expression of VPS35 was down and BACE1 was up in Alzheimer's but the direct relationship was unknown, Xiong said. "We believe impaired function of VPS35 could be a risk factor for Alzheimer's and Parkinson's diseases," Xiong said. Discovering the relationship makes VPS35 a potential biomarker for the diseases as well as a target for new therapies to keep VPS35 elevated. The accelerated aging model Xiong developed and patented will enable these future drug studies.

This unhealthy balance causes cells to accumulate more waste than their recycling systems can handle. Additionally misfolded proteins end up in the wrong cell compartment where they form aggregates that eventually kill the cell. Being in the wrong place is what enables BACE1 activity to increase: it ends up stuck in a cell compartment called the endosome where high acidity levels activate the protein. As BACE1 becomes more numerous and active, it chops up more potentially productive proteins, turning them into garbage.

"Each protein knows its destination, lifespan and when it should be degraded; everything is controlled. With aging, their trafficking, their control system is disrupted," Xiong said.

Future questions include what reduces VPS35 levels, such as increased levels of reactive oxygen species that come with age, and whether exercise can help keep them up. 'We think VPS35 will be a new, hot and hopefully productive area for Alzheimer's and Parkinson's research," Xiong said.

The protein is classified a retromer. Retromers are important to recycling inside cells. While silent in healthy adults, BACE1 plays an important role in brain development.

Provided by Georgia Health Sciences University

Friday, December 02, 2011

Socially active older adults have slower rates of health declines

Socially active older adults have slower rates of health declines


Staying connected to other people through a wide variety of social activities can yield important health consequences as you age.

02 dec 2011--That’s the message from a new study that found that older adults who maintain high levels of social activity or ramp up their social life as they age might be protected from increases in physical and cognitive issues over time.

“People have some control over their social lives, so it is encouraging to find that something many people find enjoyable—socializing with others—can benefit their cognitive and physical health,” said study author Patricia A. Thomas, Ph.D., of the Population Research Center at University of Texas at Austin.

While earlier research had established a link between health and social relations, this study sought to examine how changing social connections over time influenced health. While the elderly are vulnerable to losing formal social roles through retirement or the death of a spouse, they could still seek out social activities in other arenas.

In the study, which appears online in the December issue of the Journal of Health and Social Behavior, the researchers analyzed data from a sample of 1,667 adults older than 60 years. Data collection from participants occurred in 1986, 1989, 1994 and 2002. Participants were asked about their frequency of social activities, such as visiting with friends and family members; attending meetings, programs or clubs; and volunteering in the community over the previous 12 months. They also answered questions about cognitive and physical limitations.

Older adults who had high initial levels of social engagement that only slightly decreased over time and those who had high or medium levels of engagement that increased over time developed cognitive and physical limitations more slowly than did those with low levels of engagement that decreased over time.

Thomas pointed out, “Even if older adults weren’t socially active when they were younger, when they increase social activity later in life, it can still reduce physical and cognitive health issues.”

Asenath La Rue, Ph.D., a neuropsychologist with the Wisconsin Alzheimer's Institute at the University of Wisconsin School of Medicine and Public Health, agreed with the study’s main finding. La Rue said there has not been much reporting about the benefits gained from social interaction if a person was not socially connected when younger. “However, it’s like the chicken and egg question about which comes first,” she explained, noting that while the research was observational, epidemiology supports the fact that social interaction is beneficial for cognitive health and physical performance in older adults.

More information: Thomas, P.A. (2011) Trajectories of Social Engagement and Limitations in Late Life. Journal of Health and Social Behavior, 52(4), 430-443.

Provided by Health Behavior News Service

Tuesday, November 29, 2011

Depression can lead to heart disease

Depression may have more far-reaching consequences than previously believed. Recent data suggests that individuals who suffer from a mood disorder could be twice as likely to have a heart attack compared to individuals who are not depressed.

29 nov 2011--This process has been poorly understood — until now. A new study led by Concordia University has found that depressed individuals have a slower recovery time after exercise compared to those who are non-depressed.

These findings suggest that a dysfunctional biological stress system is at play among depressed individuals. Published in the journal Psychophysiology, the research warns of the importance of testing for cardiovascular disease among people suffering from major depression.

"There have been two competing theories as to why depression is linked to cardiovascular disease," says first author Jennifer Gordon, who is a PhD candidate at McGill University. "Depressed people may have poorer health behaviors, which may in turn lead to heart problems. The other possibility is physiological: a problem with the stress system known as the fight or flight response. Our study was the first to examine the role of a dysfunctional fight or flight response in depression in a large population."

Heart rate recovery is a powerful diagnostic tool

A total of 886 participants, who were on average 60 years old, took part in the study conducted by Concordia in association with the Montreal Heart Institute, McGill University, the Hôpital Sacré-Coeur de Montréal, the Université du Québec à Montréal and the University of Calgary.

Approximately 5 per cent of participants were diagnosed with a major depressive disorder. All individuals were asked to undergo a stress test after which their heart rate and blood pressure were recorded. Recovery heart rates and blood pressure levels were compared between depressed and non-depressed individuals.

"We found that it took longer for the heart rate of depressed individuals to return to normal," says senior author, Simon Bacon, a professor in the Concordia University Department of Exercise Science and a researcher at the Montreal Heart Institute. "Heart rate recovery from exercise is one way to measure the fight or flight stress response. The delayed ability to establish a normal heart rate in the depressed individuals indicates a dysfunctional stress response. We believe that this dysfunction, can contribute to their increased risk for heart disease."

"The take-home message of this study is that health care professionals should not only address the mental disorder, but also the potential for heart disease in patients who are suffering from major depression," adds Bacon. "Both of these health issues should be treated to minimize risk of severe consequences."

More information: http://onlinelibra … .01232.x/pdf

Monday, November 28, 2011

Fruit fight: Kiwi tops apple in blood pressure study

ORLANDO,28 nov 2011-- An apple a day may keep the doctor away, but three kiwis could lower your blood pressure.

A study presented at the American Heart Association scientific meeting in Orlando on Tuesday found that eating the fuzzy-skinned fruit with the tart green flesh three times a day lowered blood pressure more than an apple.

The eight-week study, led by Mette Svendsen, a registered dietitian at Oslo University Hospital in Norway, involved 118 subjects with an average age of 55 and mildly high blood pressure.

One group added three kiwis to their daily diet, while the other half added the proverbial apple a day. Kiwis contain lutein, which has antioxidant properties.

After eight weeks, researchers found the kiwi group's 24-hour systolic blood pressure was 3.6 mm Hg lower than that of the apple eaters, on average.

The diastolic blood pressure was also lower in the kiwi group, but that association to the fruit was not as clear, researchers said. They recommended that the findings be confirmed with a larger study.

Perhaps the most surprising thing about the kiwi fruit study was that it was conducted in Norway and not in New Zealand.

Sunday, November 27, 2011

Drugs ID'd in Most Older Adult Emergency Hospitalizations

Warfarin, insulin, oral antiplatelets, hypoglycemics implicated in most emergency hospitalizations

27 nov 2011-- Adverse drug events from commonly used medications, including warfarin, insulin, oral antiplatelet agents, and oral hypoglycemic agents, account for the majority of emergency hospitalizations in older adults in the United States, according to a study published in the Nov. 24 issue of the New England Journal of Medicine.

Daniel S. Budnitz, M.D., M.P.H., from the Division of Healthcare Quality Promotion at the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues estimated the frequency and rates of emergency hospitalization after emergency department visits for adverse drug events in adults aged 65 years or older. Adverse event data were collected for 5,077 cases identified from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project from 2007 to 2009, and were used to assess the contribution of specific medications to hospitalizations.

The investigators identified approximately 99,628 emergency hospitalizations for adverse drug events in older adults each year. Adults aged 80 years or older accounted for 48.1 percent of these hospitalizations, and almost two-thirds of the hospitalizations (65.7 percent) resulted from unintentional overdoses. Sixty-seven percent of the hospitalizations involved four medications or medication classes, alone or in combination: warfarin (33.3 percent), insulin (13.9 percent), oral antiplatelet agents (13.3 percent), and oral hypoglycemic agents (10.7 percent). In 1.2 percent of hospitalizations, high-risk medications were implicated.

"Most emergency hospitalizations for recognized adverse drug events in older adults resulted from a few commonly used medications, and relatively few resulted from medications typically designated as high-risk or inappropriate," the authors write.

Saturday, November 26, 2011

How cancer cells get by on a starvation diet

How cancer cells get by on a starvation diet



MIT researchers have found that when deprived of oxygen, cancer cells can engage an alternate metabolic pathway that allows them to use glutamine (seen above) as the starting material for synthesizing lipids.

Cancer cells usually live in an environment with limited supplies of the nutrients they need to proliferate — most notably, oxygen and glucose. However, they are still able to divide uncontrollably, producing new cancer cells.

26 nov 2011--A new study from researchers at MIT and the Massachusetts General Hospital (MGH) Cancer Center helps to explain how this is possible. The researchers found that when deprived of oxygen, cancer cells (and many other mammalian cells) can engage an alternate metabolic pathway that allows them to use glutamine, a plentiful amino acid, as the starting material for synthesizing fatty molecules known as lipids. These lipids are essential components of many cell structures, including cell membranes.

The finding, reported in the Nov. 20 online edition of Nature, challenges the long-held belief that cells synthesize most of their lipids from glucose, and raises the possibility of developing drugs that starve tumor cells by cutting off this alternate pathway.

Lead author of the paper is Christian Metallo, a former postdoc in the lab of Gregory Stephanopoulos, the William Henry Dow Professor of Chemical Engineering and Biotechnology at MIT and a corresponding author of the paper. Othon Iliopoulos, an assistant professor of medicine at Harvard Medical School and MGH, is the paper’s other corresponding author.

Alternate pathways

Much of the body’s supply of oxygen and glucose is carried in the bloodstream, but blood vessels often do not penetrate far into the body of tumors, so most cancer cells are deficient in those nutrients. This means they can’t produce fatty acids using the normal lipid-synthesis pathway that depends mostly on glucose.

In prior work, Stephanopoulos’ lab identified a metabolic pathway that uses glutamine instead of glucose to produce lipids; the new paper shows that this alternate pathway is much more commonly used than originally thought. The researchers found that in both normal and cancerous cells, lack of oxygen — a state known as hypoxia — provokes a switch to the alternate pathway.

In a normal oxygen environment, 80 percent of a cell’s new lipids come from glucose, and 20 percent from glutamine. That ratio is reversed in a hypoxic environment, Stephanopoulos says.

“We saw, for the first time, cancer cells using substrates other than glucose to produce lipids, which they need very much for their rapid growth,” Iliopoulos explains. “This is the first step to answering the question of how new cell mass is synthesized during hypoxia, which is a hallmark of human malignancies.”

The glutamine may come from within the cell or from neighboring cells, or the extracellular fluid that surrounds cells.

“There’s protein everywhere,” says Matthew Vander Heiden, the Howard S. and Linda B. Stern Career Development Assistant Professor of Biology at MIT and a co-author of the Nature paper. “The new pathway allows cells to conserve what glucose they do have, perhaps to make RNA and DNA, and then co-opt the new pathway to make lipids so they can grow under low oxygen.”

The switch from glucose to glutamine is triggered by low oxygen and allows cancer cells to thrive and proliferate in an environment with minimal glucose, though it is not clear how this is done. “Elucidating the molecular mechanism regulating this switch would be important in understanding regulation of cancer metabolism,” Stephanopoulos says. “This could be important not only for cancer cells but also other cells growing in hypoxic environments, such as stem cells, placenta and during embryonic development.”

New insights into old models

The researchers are now looking into what other unexpected sources might be diverted into lipid-synthesis pathways under low oxygen. “We had to revise models of metabolism that had been established over the past 50 years. This opens up the possibility for more exciting discoveries in this field that may impact strategies of therapy,” Metallo says.

A better understanding of metabolic pathways and their regulation raises the possibility of developing new drugs that could selectively disrupt key metabolic pathways for cancer cell survival and growth. One possible target is the enzyme isocitrate dehydrogenase, which performs a critical step in the transformation of glutamine to acetyl CoA, a lipid precursor.

“While this target is not new, our findings point to a new function and, hence, generate new ideas for drug development,” Iliopoulos says. “The better we understand the molecular basis of these phenomena, the more optimistic we can be about efforts to translate these basic results into effective treatments of cancer.”

“We’ve been looking, as a field, for almost 90 years for a metabolic pathway that could truly be used to differentiate malignant tumors from normal tissues,” says Ralph DeBerardinis, an assistant professor of pediatrics and genetics at the University of Texas Southwestern Medical Center, who was not involved in this research. He adds that more study is needed, but “if this could be exploited, that could have significant therapeutic potential.”


This story is republished courtesy of MIT News (http://web.mit.edu/newsoffice/), a popular site that covers news about MIT research, innovation and teaching.

Provided by Massachusetts Institute of Technology

Friday, November 25, 2011

Doctors could learn from Shakespeare's deep understanding of mind-body connection

Shakespeare was a master at portraying profound emotional upset in the physical symptoms of his characters, and many modern day doctors would do well to study the Bard to better understand the mind-body connection, concludes an analysis of his works, published in Medical Humanities.

25 nov 2011--Kenneth Heaton, a medical doctor and extensively published author on William Shakespeare's oeuvre, systematically analysed 42 of the author's major works and 46 of those of his contemporaries, looking for evidence of psychosomatic symptoms.

He focused on sensory symptoms other than those relating to sight, taste, the heart, and the gut.

He found that Shakespeare's portrayal of symptoms such as dizziness/faintness, and blunted or heightened sensitivity to touch and pain in characters expressing profound emotions was significantly more common than in works by other authors of the time.

Vertigo/giddiness/dizziness is expressed by five male characters in "Taming of the Shrew", "Romeo and Juliet", "Henry VI" part 1, "Cymbeline" and "Troilus and Cressida". The nearest approximation in contemporaries' works was one incident in John Marston's "The Malcontent".

There are at least 11 instances of breathlessness associated with extreme emotion in "Two Gentlemen of Verona", "The Rape of Lucrece", "Venus and Adonis", and "Troilus and Cressida", compared with just two in the works of other writers.

Fatigue/weariness as a result of grief or distress is a familiar sensation among Shakespeare's characters, most notably in "Hamlet", "The Merchant of Venice", "As You Like It", "Richard II" and "Henry IV" part 2. This crops up twice as frequently as in other contemporaries' works, argues Dr Heaton.

Disturbed hearing at a time of high emotion occurs in "King Lear", "Richard II" and "King John" while blunted/exaggerated senses are portrayed in "Much Ado about Nothing", "Venus and Adonis", "King Lear", "Love's Labour's Lost" and "Coriolanus".

"Shakespeare's perception that numbness and enhanced sensation can have a psychological origin seems not to have been shared by his contemporaries, none of whom included such phenomena in the works examined," writes Dr Heaton.

The Bard also uses coldness - for example, "Romeo and Juliet" - and faintness to convey shock, including in "Titus Andronicus", "Julius Caesar", "Love's Labour's Lost", and "Richard III", significantly more frequently than other writers of the period.

Dr Heaton concludes that his data show that Shakespeare "was an exceptionally body-conscious writer," suggesting that the technique was used to make his characters seem more human and engender greater empathy or raise the emotional temperature of his plays and poems.

And his findings should encourage doctors to remember that physical symptoms can have psychological causes, he suggests.

"Many doctors are reluctant to attribute physical symptoms to emotional disturbance, and this results in delayed diagnosis, overinvestigation, and inappropriate treatment," he writes.Link

"They could learn to be better doctors by studying Shakespeare. This is important because the so-called functional symptoms are the leading cause of general practitioner visits and of referrals to specialists," he says.

Provided by British Medical Journal

Thursday, November 24, 2011

People with early Alzheimer's disease may be more likely to have lower BMI

Studies have shown that people who are overweight in middle age are more likely to develop Alzheimer's disease decades later than people at normal weight, yet researchers have also found that people in the earliest stages of Alzheimer's disease are more likely to have a lower body mass index (BMI). A current study examines this relationship between Alzheimer's disease and BMI.

24 nov 2011--The study, published in the November 22, 2011, print issue of Neurology, the medical journal of the American Academy of Neurology, examined 506 people with advanced brain imaging techniques and analyses of cerebrospinal fluid to look for biomarkers for Alzheimer's disease, which can be present years before the first symptoms begin. The participants, who were part of the Alzheimer's Disease. Neuroimaging Initiative, included people with no memory problems, people with mild cognitive impairment, or mild memory problems, and people with Alzheimer's disease.

The study found that in people with no memory or thinking problems and in people with mild cognitive impairment, those who had the Alzheimer's biomarkers were also more likely to have a lower BMI than those who did not have the biomarkers.

For example, 85 percent of the people with mild cognitive impairment who had a BMI below 25 had signs of the beta-amyloid plaques in their brains that are a hallmark of the disease, compared to 48 percent of those with mild cognitive impairment who were overweight. The relationship was also found in people with no memory or thinking problems.

"These results suggest Alzheimer's disease brain changes are associated with systemic metabolic changes in the very earliest phases of the disease," said study author Jeffrey M. Burns, MD, MS, of the University of Kansas School of Medicine in Kansas City and a member of the American Academy of Neurology. "This might be due to damage in the area of the brain called the hypothalamus that plays a role in regulating energy metabolism and food intake. Further studies should investigate whether this relationship reflects a systemic response to an unrecognized disease or a long-standing trait that predisposes a person to developing the disease."

Provided by American Academy of Neurology